Healthcare Provider Details

I. General information

NPI: 1811730229
Provider Name (Legal Business Name): FORTISSIMO HEALTHCARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2024
Last Update Date: 09/03/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1338 PHAY AVE
CANON CITY CO
81212-2311
US

IV. Provider business mailing address

PO BOX 62669
COLORADO SPRINGS CO
80962-2669
US

V. Phone/Fax

Practice location:
  • Phone: 719-219-2400
  • Fax:
Mailing address:
  • Phone: 719-219-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DAN GIOIA
Title or Position: OWNER / OFFICIAL
Credential: MD
Phone: 352-256-6886